Salivary Progesterone Levels in Female Patients with a History of Idiopathic Scoliosis: A Retrospective Cross-Sectional Study

Idiopathic scoliosis is a condition characterized by a three-dimensional curvature of the spine. However, in addition to the spinal curvature, it has also been reported that patients with idiopathic scoliosis can display other abnormal physiologic parameters, such as hormone imbalances, genetic variants, and micronutrient deficiencies. The present study evaluates the salivary progesterone levels from a historical cohort of patients seeking treatment at a single integrative medicine clinic. A group of female patients with a history of idiopathic scoliosis is compared to a group of non-scoliosis female patients. Salivary progesterone levels were 49% higher in non-scoliosis patients compared to the scoliosis group (p < 0.05). When compared by the menstrual cycling status, non-scoliosis females had a 60% higher average progesterone level, while the progesterone level among non-cycling, non-scoliosis females was 39% higher than non-cycling scoliosis females. These results suggest a potential relationship between salivary progesterone and idiopathic scoliosis among female patients.

Manipulation under anesthesia for patients with failed back surgery: retrospective report of 3 cases with 1-year follow-up

OBJECTIVE

This report describes the treatment of 3 patients with previous spinal fusion surgery who had subsequently regressed to their previous levels of pain and disability.

CLINICAL FEATURES

Three patients with chronic intractable pain presented to a private integrative medicine clinic for manipulation under anesthesia (MUA) evaluation. All 3 patients had previously had lumbar spine fusion surgery for intervertebral disk herniation. All surgeries were performed at least 2 years before clinical presentation. Patients had plateaued with other conservative pain management strategies before seeking MUA treatment.

INTERVENTION AND OUTCOMES

The patients were evaluated for MUA. The patients received a serial MUA over 3 consecutive days by trained chiropractic and osteopathic physicians. Outcome assessments used for each patient included a quadruple numerical pain rating scale and functional rating index. Patients completed a course of post-MUA physiotherapy and rehabilitation lasting 8 weeks immediately after the serial MUA. Clinical improvements were observed in all 3 outcome assessments after the MUA, the post-MUA therapy, and were essentially maintained 1 year after conclusion of treatment.

CONCLUSION

Three patients with failed back surgery were treated conservatively using MUA by trained chiropractic and osteopathic physicians followed by 8 weeks of post-MUA therapy. Pain and disability outcomes all improved immediately following treatment.

Changes in chronic low back pain and cardiovascular risk factors using a homeopathic human chorionic gonadotropin-based weight loss program: a case report

OBJECTIVE

The purpose of this case report is to describe the changes in body weight and biochemical markers in a patient who completed a homeopathic human chorionic gonadotropin protocol.

CASE REPORT

A 52-year-old man reported to an integrative medical center (including chiropractic and osteopathic physicians) for chronic low back pain. The patient reported a 20-year history of chronic, episodic low back pain. A course of spinal manipulative therapy was delivered; however, because of the lack of resolution of symptoms, a radiographic examination was performed, the result of which was essentially normal. Laboratory studies demonstrated hypercholesterolemia, hyperlipidemia, uricemia, and elevated blood glucose. A dietary change in treatment approach was selected.

INTERVENTION AND OUTCOME

The patient was instructed to take 10 drops of a homeopathic human chorionic gonadotropin product under the tongue 5 times daily. His total daily energy (calorie) was limited for the first 30 days of the program while on the homeopathic product. After 4 months, the patient lost a total of 71 lb, pain and disability scores improved, and reductions in serum cardiovascular markers were noted.

CONCLUSION

The findings of this study showed that weight loss seemed to affect the patient's chronic low back pain and cardiovascular risk factors.

Adolescent idiopathic scoliosis treatment using pettibon corrective procedures: a case report

OBJECTIVE

To investigate the possible benefits of using Pettibon corrective procedures to reduce the curvature associated with idiopathic scoliosis. These procedures were tested to determine potential effectiveness in a single patient.

CLINICAL FEATURES

A patient with a 35 degrees left convex thoracolumbar scoliosis was treated using Pettibon corrective procedures. Initial and follow-up outcome measures included a Borg pain scale, a Functional Rating Index, a balance test, and radiographic analysis.

INTERVENTION AND OUTCOME

The patient was treated using a combination of manipulative and rehabilitative procedures designed to restore normal sagittal curves and reduce the severity of the coronal curvatures. After six weeks of treatment, the post treatment radiograph revealed a 20 degrees left convex thoracolumbar scoliosis, as well as decreases in the Borg pain scale from six to two, and Functional Rating Index score from 18/40 to 7/40 after the trial period. Her balance time increased from 18 seconds to 56 seconds.

CONCLUSION

Pettibon corrective procedures seemed to be effective at reducing the thoracolumbar scoliosis 15 degrees (43%) after six weeks. The subjective and objective results of this case study warrant further such investigations.

Spinal manipulation and anterior headweighting for the correction of forward head posture and cervical hypolordosis: A pilot study

OBJECTIVE

To evaluate the effectiveness of Pettibon spinal manipulation and anterior headweighting for correct cervical hypolordosis and forward head posture, quantified by measurements taken from pre and post intervention lateral cervical radiographs.

METHODS

A total of 15 subjects were selected for investigation at random. An initial seated lateral cervical radiograph was taken to evaluate forward head posture and the amount of cervical lordosis. A series of 3 manipulative procedures were performed, followed immediately by introduction of an anterior headweight device. This headweight device was worn for 5 minutes while walking on a treadmill. A post intervention seated lateral cervical radiograph was taken while each subject wore the headweight. Measurements of cervical lordosis and forward head posture were again quantified and compared to the initial radiographs.

RESULTS

The average overall decrease in forward head posture among all subjects was 0.83 inches. The largest reduction in forward head posture was 1.25 inches. One subject failed to show any reduction. The largest and smallest improvements in the cervical lordosis were 23 degrees and 4 degrees , respectively. The average increase in cervical lordosis for all subjects was 9.9 degrees .

CONCLUSIONS

This specific protocol was able to provide measurable improvement in cervical lordosis and reduction of forward head posture after only 1 session. However, it is not known which component, the spinal manipulation or the anterior headweighting, made the biggest impact. This study shows the immediate effects of spinal manipulation and headweighting combined. Future research should focus on the headweighting effects over a longer period of time. Additionally, anterior headweighting alone needs to be tested to evaluate its effectiveness as a sole treatment intervention.

Management of a 59-year-old female patient with adult degenerative scoliosis using manipulation under anesthesia

OBJECTIVE

Manipulation under anesthesia (MUA) is an outpatient procedure that is performed to restore normal joint kinematics and musculoskeletal function. This article presents a case of a patient with idiopathic lumbar degenerative scoliosis who developed intractable pain as an adult and reports on the outcomes following a trial of MUA.

CLINICAL FEATURES

A 59-year-old female patient presented to a chiropractic office with primary subjective symptoms of lower back and bilateral hip pain. Numerical pain rating scores were reported at 8 of 10 for the lower back and 9 of 10 for the sacroiliac joint/gluteal region. A disability score using a functional rating index demonstrated a score of 26 of 40 (or 64% disability). Over the preceding 5 years, the patient had tried a number of conservative therapies to relieve her pain without success.

INTERVENTION AND OUTCOME

The patient was evaluated for MUA. The patient was scheduled for a serial MUA over 3 days. Numerical pain rating scores 8 weeks after the MUA were 1 of 10 for the lower back and 3 of 10 for the sacroiliac joint. Her disability rating decreased to 11 of 40 (28%). Radiological improvements were also observed. These outcomes were maintained at 6-month follow-up.

CONCLUSION

Pain, functional, and radiographic outcomes demonstrated improvements immediately following treatment for this patient.